2017 Winter: Creating a Culture of Well-being at an Academic Health Center

Reports from various sources indicate that chronic stress and burnout is prevalent in the health professions, affecting over half of primary care practitioners and even more in several specialties. This trend may begin earlier with the observed decline in empathy during medical student and residency training and the alarming rates of burnout in medical and other students in the health professions. As educators, administrators and academic health leaders grapple with developing interventions to address these issues, evidence is emerging that programs aimed at fostering resilience and stress reduction such as mindfulness, reflective capacity and appreciate inquiry, also lead to increased empathy and improved well being. Furthermore, the AAMC, ACGME and other national organizations are working to improve the learning environment and facilitate the creation of a culture of well-being at academic health centers. The IAMSE 2017 Winter Web Seminar Series has an impressive panel of leaders who will share their expertise on trainee stress and burnout and curricular interventions that have been shown to address these issues. The series is designed to help faculty, course directors and administrators understand the issues and hear about successful approaches and innovations to improve the health and well-being of students, residents and faculty. In Session 1, Dr. Colin West will provide an overview to the issue of student stress and physician burnout and share outcomes from the large studies conducted by the team at Mayo Clinic. In Sessions 2-5, Drs. Stuart Slavin (St. Louis University), Catherine Pipas (Dartmouth), Adi Haramati (Georgetown) and Michael Krasner (University of Rochester) will describe the rationale and approaches they undertook at different institutions and in various learners and trainees. We hope that this series will bring these serious issues to your awareness and provide you with possible solutions and ideas on how to move forward at your institution.

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January 5, 2017 at 12:00 pm

Physician burnout and distress ‚Äď causes, consequences, and a structure for solutions

Presenter:

Originally from Seattle, Dr. West received his M.D. and Ph.D. in Biostatistics from the University of Iowa in 1999. He completed residency and chief residency in internal medicine at Mayo Clinic, and joined the faculty in General Internal Medicine in 2004. He is currently Professor of Medicine, Medical Education, and Biostatistics at Mayo. He directs the evidence-based medicine curriculum for the medical school, and is an Associate Program Director within the internal medicine residency program. He is also the Research Chair of General Internal Medicine. Dr. West’s research has focused on medical education and physician well-being, and he is Co-Director of the Mayo Clinic Program on Physician Well-Being. Working closely with Tait Shanafelt and Lotte Dyrbye, his work documenting the epidemiology and consequences of physician distress, as well as emerging research on solutions, has been widely published in prominent journals including Lancet, JAMA, Annals of Internal Medicine, and JAMA Internal Medicine.

This session will briefly review data on physician burnout and dissatisfaction before considering current knowledge of the contributors to and consequences of physician burnout and distress. We will then discuss evidence in support of both individual-focused and organizational solutions, and how these may be aligned with the known drivers of burnout and distress to optimize benefits.

Seminar Archive
January 12, 2017 at 12:00 pm

Improving Medical Student Mental Health: A Multifaceted Approach

Presenter: Stuart Slavin, MD, MEd

Stuart Slavin, M.D., M.Ed. is Associate Dean for Curriculum and Professor of Pediatrics at Saint Louis University School of Medicine.

A graduate of Saint Louis University School of Medicine, Dr. Slavin completed his residency training in pediatrics at UCLA and then served as a faculty member there for 17 years before returning to St. Louis in 2004. In addition to his administrative duties at Saint Louis University, Dr. Slavin teaches actively in the undergraduate medical curriculum and serves as director of the Applied Clinical Skills series of courses. He has led significant efforts to improve the mental health and well-being of medical students at SLU and has recently expanded his work to residents, college students, and high school students.

Dr. Slavin has given workshops and presentations at regional and national medical education meetings as well as at medical schools across the US and internationally. He has received numerous education and teaching awards including the Alpha Omega Alpha Robert J. Glaser Distinguished Teacher Award in 2013.

Dr. Slavin will provide an overview of a multi-faceted initiative at Saint Louis University School of Medicine that is designed to enhance the mental health of pre-clinical medical students. He will describe the various components of the initiative, the mental health outcomes for students, and the resilience and mindfulness curriculum that is taught to the students.

Seminar Archive
January 19, 2017 at 12:00 pm

Strategies for promoting personal health & wellness and leading change

Presenter: Catherine Pipas

Dr. Pipas is a Professor in Community and Family Medicine at Dartmouth’s School of Medicine. She has served as Assistant Dean, Vice Chair, Director of the Office of Community-Based Education and Research and Director of Dartmouth’s Regional Primary Care Center, a collaborative of 23 NCQA Patient-Centered Medical Homes. Recognitions include: Academy of Master Educators, Clinical Teacher of the Year, Humanism in Medicine and AOA Honors Societies. She completed an MPH at The Dartmouth Institute for Health Policy and Clinical Practice, directs Dartmouth’s Leadership and Public Health Curriculum. She has served as Faculty for the American Association of Medical Colleges (AAMC) National LEAD Certificate Program and teaches Applied Leadership for the Leadership Preventive Medicine Residency at Dartmouth Hitchcock Medical Center. She directs Experiential Leadership Development at Dartmouth Medical School and is the Co-Director of a new course Healthcare, Population Health and the Practicing Physician. She is Past President of the New Hampshire Academy of Science and serves on the Board of Directors for the Society of Teachers of Family Medicine, the Board of Trustees of Kimball Union Academy, and the AAMC Council of Faculty and Academic Societies.

She teaches and partners with Health Care Providers globally and to achieve her vision of Healthy Individuals Contributing to Healthy Communities. Her Areas of Interest, Experience and Consulting Expertise are Health and Wellness at the Individual, Public Health and Population Level. She teaches and speaks on personal wellness and improvement strategies to achieve ‚ÄúThe Quadruple Aim‚ÄĚ with focus on performance training that minimizes burnout and promotes resilience.

Leaders in Academic Medical Centers face a need for robust change in healthcare. They are faced with diminished resources, expanded expectations and are called upon daily to lead change and achieve the ‚ÄúTriple Aim‚ÄĚ of better health, better care and lower costs. Leaders of change also face increased stress and burnout. Thomas Bodenheimer‚Äôs, ‚ÄúQuadruple Aim‚ÄĚ (1) challenges leaders to prioritize their own health in order to effectively promote the health of others. By applying the continuous quality improvement (CQI) process at the personal level, leaders can demonstrate the knowledge and skills to lead change while simultaneously promoting personal improvement. This session will focus on describing strategies for leading change at the personal level. Participants will have an opportunity to reflect on the components of the process of change, their own resilience, personal vision and to strengthen their commitment to personal health choices. They will critically analyze and prioritize areas for personal improvement and define global aims, SMART objectives, actionable steps, timelines, challenges and resources for sustainability. The process begins with a personal needs assessment and ends with an actionable personal improvement plan. Participants will be supported to implement their personal plans and to partner and disseminate tools with team members and colleagues at their home institution. At the conclusion of this seminar, the participant will be able to:

  • Describe the importance of achieving ‚ÄúThe Quadruple Aim‚ÄĚ
  • Discuss Strategies for Leading Change Personally and at the Team level
  • Adapt the model for systems improvement as a framework from which to apply personal health improvement.
Seminar Archive
January 26, 2017 at 12:00 pm

The Imperative for Incorporating Mind-Body Medicine in Health Professions Education

Presenter: Adi Haramati, PhD

Aviad ‚ÄúAdi‚ÄĚ Haramati, PhD, is Professor of Integrative Physiology in the Departments of Biochemistry, Molecular & Cellular Biology and Medicine (Nephrology), Director of the Center for Innovation and Leadership in Education (CENTILE), and co-director of the CAM Graduate Program at Georgetown University Medical Center. He received a PhD in Physiology from the University of Cincinnati College of Medicine and came to Georgetown in 1985 after spending 5 years at Mayo Clinic. His research interests were in renal and electrolyte physiology, but now focuses on medical education and rethinking how health professionals are trained.

Dr. Haramati taught physiology for over 35 years and has been recognized with multiple awards including the Alpha Omega Alpha Robert J. Glaser Distinguished Teaching Award from the Association of American Medical Colleges, and the Master Scholar Award from the International Association of Medical Science Educators (IAMSE). He served as IAMSE’s first president and hosted two IAMSE meetings (in 1999 and 2003).

Dr. Haramati led a broad, NIH-funded educational initiative to incorporate complementary and integrative medicine into the medical curriculum at Georgetown; served as the founding Vice-Chair of the Consortium of Academic Health Centers for Integrative Medicine, and chaired several of the Consortium’s International Congresses on Integrative Medicine and Health. In October 2015, he convened the first CENTILE Conference on Strategies to Promote Resilience, Empathy and Well-being in the Heath Professions. Dr. Haramati seeks to improve medical education across the globe, especially with regard to the intersection of science, mind-body medicine and professionalism and has been a visiting professor at over 80 medical schools around the world.

More than half of practicing physicians exhibit characteristics of chronic stress and burnout. This trend may begin earlier with the observed decline in empathy during medical student training and alarming rates of burnout in medical and other students in the health professions. In this presentation, Dr. Haramati will review published outcomes on curricular interventions to help students and faculty manage stress, foster empathy and build resilience. He will also share his perspective on why it is essential to incorporate mind-body techniques into the training curriculum for all health professionals‚ÄĒsomething that will require both skill and courage.

Seminar Archive
February 2, 2017 at 12:00 pm

Cultivating Resilience and Reducing Burnout for Health Professionals: The Power of Presence, Reflective Practice and Appreciative Dialogue

Presenter: Michael Krasner, MD

Mick Krasner MD, Professor of Clinical Medicine at the University of Rochester School of Medicine and Dentistry, practices primary care internal medicine in Rochester, New York. He has been teaching Mindfulness-Based interventions to patients, medical students, and health professionals for more than 16 years, involving nearly 2000 participants, including over 600 health professionals, and is engaged in a variety of research projects including the investigations of on the immune system in the elderly, chronic psoriasis, and medical student stress and well-being. He was the project director of Mindful Communication: Bringing Intention, Attention, and Reflection to Clinical Practice, sponsored by the New York Chapter of the ACP reported in JAMA in September, 2009.

Dr. Krasner graduated from the UC San Diego School of Medicine, completed residency in combined Internal Medicine/Pediatrics at the University of Rochester School of Medicine and Dentistry and is currently engaged in direct patient care, medical student and residency education, post-graduate medical education, and research in the University’s Center for Mind-Body Research. He has shared his work in peer-reviewed publications, scientific assemblies, visiting professorships, and workshops throughout the world, focusing primarily on the roots of Hippocratic medicine through the cultivation of attention, awareness, and reflection. His personal mission is centered on compassion in medicine and envisions a health professional-patient relationship where healing is truly bidirectional, care goals are mutually derived, and the uniqueness of the clinical encounter reflects the central act of mutual high regard.

During this session, Dr. Krasner will explore the issue of burnout, and its effects on quality of care and quality of caring in the medical encounter. After defining resilience, he will then examine ways to cultivate resilience in health professional development. Particular focus will be given to Mindful Practice, an approach designed cultivate resilience through the cultivation of mindful attention and awareness, reflections and sharing among physicians and other health professionals of clinical narratives, and the use of appreciative dialogue in identifying the strengths and capacities that lead to greater meaning, satisfaction and resilience in medical practice.

Seminar Archive